National Alliance on Mental Illness
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Generic name: fluvoxamine (floo VOKS a meen)
Medication class: Selective serotonin reuptake inhibitor (SSRI) antidepressant
All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.
What is Luvox® and what does it treat?
Fluvoxamine is an antidepressant medication that works in the brain. It is approved for the treatment of major depressive disorder (MDD), social phobia, and obsessive compulsive disorder (OCD) in adults and children ages 8 and older.
Symptoms of depression include:
Social phobia/social anxiety disorder is a fear of situations where one may feel as if they are being judged by others. Symptoms include:
Obsessive Compulsive Disorder (OCD) occurs when a person experiences the following symptoms at the same time:
What is the most important information I should know about Luvox®?
Do not stop taking fluvoxamine, even when you feel better. Only your healthcare provider can determine the length of treatment that is right for you.
Missing doses of fluvoxamine may increase your risk for relapse in your symptoms.
Stopping fluvoxamine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, dizziness, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).
Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for "switching" from depression into mania. Symptoms of mania include "high" or irritable mood, very high self esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).
Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.
Are there specific concerns about Luvox® and pregnancy?
If you are planning on becoming pregnant, notify your healthcare provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers. For women who take antidepressant medications during weeks 13 through the end of their pregnancy (second and third trimesters), there is a risk that the baby can be born before it is fully developed (before 37 weeks).
For mothers who have taken SSRIs during their pregnancy, there appears to be less than a 1% chance of infants developing persistent pulmonary hypertension. This is a potentially fatal condition that is associated with use of the antidepressant in the second half of pregnancy. However, women who discontinued antidepressant therapy were five times more likely to have a depression relapse than those who continued their antidepressant. If you are pregnant, please discuss the risks and benefits of antidepressant use with your healthcare provider.
Caution is advised with breastfeeding since fluvoxamine does pass into breast milk.
What should I discuss with my healthcare provider before taking Luvox®?
How should I take Luvox®?
Fluvoxamine is usually taken 2 times per day with or without food. The extended release formulation may be taken 1 time per day with or without food.
Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks.
The dose usually ranges from 50 mg to 300 mg. Only your healthcare provider can determine the correct dose for you.
Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.
The extendedelease forms should be swallowed whole. They should not be chewed, crushed, or broken.
What happens if I miss a dose of Luvox®?
If you miss a dose of fluvoxamine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
What should I avoid while taking Luvox®?
Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.
What happens if I overdose with Luvox®?
If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.
A specific treatment to reverse the effects of fluvoxamine does not exist.
What are the possible side effects of Luvox®?
Common Side Effects
These will often improve over the first week or two as you continue to take the medication.
Sexual side effects, such as problems with orgasm or ejaculatory delay often do not diminish over time.
Rare Side Effects
Increased bleeding (e.g., gums may bleed more easily), low sodium blood levels (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering), teeth grinding
Serious Side Effects
Serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), seizure
Are there any risks of taking Luvox® for long periods of time?
To date, there are no known problems associated with long term use of fluvoxamine. It is a safe and effective medication when used as directed.
What other medications may interact with Luvox®?
Fluvoxamine should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), rasagiline (Azilect®), and selegeline (Emsam®).
Although rare, there is an increased risk of serotonin syndrome when fluvoxamine is used with other medications that increase serotonin, such as other antidepressants, migraine medications called “triptans” (e.g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), and the antibiotic linezolid (Zyvox®).
Fluvoxamine may increase the levels and effects of:
Fluvoxamine may decrease the effects of clopidogrel (Plavix®).
Fluvoxamine may increase the effects of other medications that can cause bleeding (e.g., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®), and aspirin).
Combining fluvoxamine with ramelteon (RozeremTM), tizanidine (Zanaflex®), thioridazine (Mellaril®), pimozide, or alosetron (Lotronex®) is not recommended.
How long does it take for Luvox® to work?
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Provided by the College of Psychiatric and Neurologic Pharmacists
Summary of Black Box Warnings
Suicidal Thoughts or Actions in Children and Adults